Despite vast strides in recent years, the health of older AI/ANs still lags far behind the majority population. The life expectancy of AI/ANs is 8 years less than non-Indians. Diabetes is 4-8 times more common in A is compared to the general population. Although the incidence of coronary heart disease has increased and is the leading cause of mortality among AI/ANs. In some tribes smoking rates approach 60-70%, and is even higher among urban dwellers. Taken together, pneumonia and influenza are the fourth leading cause of death AI/ANs, with which greater mortality for those >65 than their general US counterparts. Among Native elders death due to tuberculosis is dramatically increased for all age groups greater than or equal to 65 years in the greater US population in some cases as much as 850% higher. The Division of AI/AN Programs at the UCHSC houses 2 programs that are centrally concerned with understanding and reducing health disparities that plague Native elders: the NIA-sponsored Native Elder Research Center (NERC) and the AoA-funded Native Elder Health Care Resource Center (NEHCRC). The former prepares young AI/AN health scientists to develop independent geriatric research careers. The latter conducts training, technical assistance, continuing education, and information dissemination targeted to health professionals and paraprofessionals who provide eldercare in Native communities. This RPP builds upon these ongoing efforts. It will promote high quality, culturally competent, theoretically sound, and programmatically relevant research through a series of projects that promise to shed important light on the barriers as well as facilitators to improved health status and functioning of elder AI/ANs. Individual projects address improving the quality of diabetic care, increasing participation in clinical preventive services such as immunization and cancer detection/management, as well as smoking cessation. This RPP, through its synergistic relationship with the NERC and NEHCRC, will significantly increase the extent of as well as capacity for health services research undertaken by American Indian/Alaska Native investigators, focused on an older racial minority population that is the most in need.